Acute Stroke Therapy: Combination Drugs and Multifunctional Neuroprotectants

Ischemic stroke is responsible for about one third of all deaths in industrialized countries and is the major cause of serious, long-term disability in adults over the age of 45. It stands to reason that there is a need for pharmacotherapy to treat acute ischemic stroke. In over two decades of research, the hope of developing a neuroprotective drug that effectively reduces the severity of damage after stroke has not been realized. However, considerable insights have been gained into the mechanisms and cascade of events that occurs following stroke as well as an improved understanding of neuronal injury and cell death. Recent studies in humans indicate many parallels with animal studies not only in the nature of events following ischemia, but also in their time course. Multiple pathways are known to be involved and yet the majority of treatments are still being designed to target a single effector in these pathways. Combinations of drugs, or drugs, which have multiple actions, targeting several pathways may prove to be a more successful strategy.